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I expect it is the familiar problem that NICE judges cost effectiveness without regard to cash flows in the NHS - ie the provider Trust pays up, may receive reimbursement from the purchaser.
The purhaser paye from it's annual budget but is unlikely to recoup its outlay that year.
NICE do need to appreciate how finance operates within the NHS - the High Court may also be unaware of the many pressures on budgets. If we are to implement NICE recommendations we will need a system that operates the way NICE thinks it should.
We need a funding system that operat